When am I eligible for a conversion policy?

· In Kansas, if you have coverage through an employer’s fully insured group health plan and you lose that coverage, you are eligible to buy a conversion policy. A conversion policy is an individual policy you get from the company that insured your employer’s group plan. If you had family coverage under your prior group plan, your dependents can elect to buy a conversion policy as well.

· To qualify for a conversion policy, you must have had at least 3 months of continuous coverage through an employer’s fully insured group health plan. In addition, you must not be covered under, or eligible for coverage under Medicare, other group coverage, or other substantially similar individual coverage. Further, you must have used up any COBRA or state continuation coverage available to you. You must apply for a conversion policy within 31 days of the termination of the group plan.

· You do not need to be HIPAA eligible to buy a conversion policy. However, if you do elect a conversion policy, you will lose your HIPAA eligibility status.

What does a conversion policy cover?

· It depends. Conversion policy benefits must be substantially similar to those under your former plan, unless you elect reduced benefits for a reduced premium.

What about coverage for my pre-existing condition?

· Your conversion policy cannot impose a new pre-existing condition exclusion period. However, you may have to satisfy any unfinished portion of any pre-existing condition exclusion period from your former health plan.

How much can I be charged for a conversion policy?

· Conversion policies may cost much more than your previous group plan. There is no limit on what you can be charged for conversion policies. You may be charged higher rates based on your health, age, gender, and other factors. Contact the Kansas Department of Insurance if you have questions about conversion policy premiums.

Can my conversion policy be canceled?

· Conversion policies, like other individual health insurance policies, are guaranteed renewable. Your coverage cannot be canceled because you get sick. You have this protection provided you pay the premiums, do not defraud the company, and, in the case of managed care plans, continue to live in the plan service area. Also, if you become eligible for Medicare or other insurance with similar benefits, you will no longer be eligible for a conversion policy.